Flu vaccine: alarm at drop in jab take-up among at-risk groups - as number in hospital hits 10 year high

Uptake of the flu vaccine has fallen across at-risk groups this year, amid an outbreak threatening to overwhelm the NHS.

In England, only one third of pregnant women have had their flu jab so far this winter, the lowest figure in at least a decade, analysis of official figures shows. The number of toddlers, elderly people and vulnerable adults vaccinated against flu are all lower than a year ago.

This is despite hospital admissions reaching their highest level in a decade, as well as evidence that the children’s vaccine also protects against Strep A infections.

A similar fall in take-up is being seen in Scotland and Wales.

NHS director of vaccinations and screening, Steve Russell, said it was “heart-breaking to hear the stories of those who have been hospitalised with flu” and urged more people to come forward for the vaccine.

He said: "With hospital cases for flu at their highest yet this winter with 5,500 beds occupied by patients with flu and more than 9,000 patients with Covid last week, the message is clear – anyone who has been invited for a flu vaccine but yet to take it up, should come forward now.”

Why are fewer people having the flu jab?

Some health experts have suggested the public is suffering from ‘vaccine fatigue’ - reluctance to get yet more jabs after the coronavirus pandemic. Research from Well Pharmacy published last month showed 14% of people were bored of hearing about vaccines.

Its poll of 2,000 people across the UK found 25% of respondents felt that there was a sense of vaccine fatigue following several Covid jabs over the last few years.

There is not yet good evidence to explain why vaccine take-up for two- and three-year-olds is lower than last year, according to the UK Health Security Agency (UKHSA). But it said current vaccination rates among this age group were comparable to the levels seen before the coronavirus pandemic.

Separate analysis by the UKHSA suggests the nasal spray flu vaccine offered to children may also help reduce the rate of group A strep infections. The study compared rates of group A strep (GAS) infections in pilot areas where the nasal spray was offered to all primary school children from 2013 to 2017, comparing them to other areas where the vaccine was not being offered as widely.

Strep A infections are at very high levels this year and Invasive Group A Streptococcal disease has so far killed at least 37children across the UK this winter.

Are lower levels of vaccination to blame for the current flu outbreak?

Not according to Sarah Scobie, the deputy director of research at the Nuffield Trust.

She said: “The uptake of the flu vaccine has been lower than last year when it took place alongside a hard push from the government to boost Covid immunity as the Omicron variant spread more rapidly. However, the flu vaccine uptake for most groups has been above the level for this time of year compared with before the pandemic.

“This winter has seen an unusually harsh and early flu season which has contributed to the additional pressure on emergency and urgent care. High levels of flu in the population is driving higher flu hospitalisations rather than lower vaccine levels within specific groups of people.”

‘Not having the vaccine was just stupid’

A woman from Buckinghamshire has said she "will be the first in the queue” for a flu jab next year after spending two weeks in hospital with flu and pneumonia after being taken to hospital on Boxing Day when she became severely ill.

Carole Hildreth, 64, was left needing oxygen and IV antibiotics in Stoke Mandeville Hospital’s respiratory ward in Aylesbury, after contracting the infections which left her feeling exhausted, unable to walk to the toilet, and regretting not getting the jab.

Carole said: “Having flu like this came as a massive shock, totally out of the blue. Looking back, not having the vaccine was just stupid. I’m always healthy and I felt invincible I suppose – we have had a number of vaccines throughout the pandemic.

“I’ve been in hospital for nearly two weeks, first in the emergency department and then on a respiratory ward. I now struggle to get enough energy to walk to the toilet – never mind chasing after my grandchildren like I usually do, and I even have to plan if I have enough energy to brush my teeth.”

She praised NHS staff who “kept me alive”, adding: “I’d urge everyone please, please, please, if you get the chance to have a vaccine, take it. I’ll be first in the queue next time.”

Fall in pregnant women getting flu vaccine

In England, just 33% of pregnant women had taken their flu jab by January 1, compared to 37% by the same point a year ago, NationalWorld’s analysis of UKHSA data shows.

The number of pregnant women taking up the jab by the end of the calendar year has fallen to its lowest level in at least 10 years.

Pregnant women have a higher chance of developing complications such as bronchitis or pneumonia if they get flu, particularly in the later stages of pregnancy. Having flu during pregnancy can also cause premature births, babies with low birthweight and even stillbirth or death, according to the NHS.

But Ms Scobie warned that the official figures may under-count the number of pregnant women getting vaccinated.

She said: “Catching flu while pregnant can result in more serious illness, so getting the vaccine is important. However, data for pregnant women taking up the flu vaccine is not high quality and can underestimate the number of women vaccinated.”

Flu vaccination in England, Wales, Scotland and Northern Ireland compared

In England, the vaccination of pre-school children and vulnerable adults of working age have both fallen back to pre-pandemic levels, after having seen a boost in 2020 and 2021.

About 69,000 fewer two- and three-year-olds have been vaccinated against flu so far this season, when compared with the same point the year before. Forty percent of two-year-olds had received a flu vaccine by January 1, far lower than the 47% who had been vaccinated by that point the year before.

A similar fall was seen for three-year-olds, with 42% vaccinated by January 1, compared with 49% in the same period the year before.

Vaccination rates among the elderly are slightly lower than at this point last year, although above pre-pandemic levels. Among over-65s, 78% had received a flu jab as of January 1, higher than the target of 75% set by the World Health Organization.

In Wales, 74% of over-65s had been vaccinated against flu as of December 27, lower than the 75% target set by the World Health Organization. Some 76% had been vaccinated by the same point the year before, figures from Public Health Wales show.

There was a more marked fall in uptake among parents of pre-school children. Only 40% of children aged two and three had been vaccinated as of December 27, compared with 44% at this point the year before.

In Scotland, 85% of over-65s had been vaccinated against flu as of January 1, compared with 90% by the same point the year before, figures from Public Health Scotland show. Data on the number of pre-school children and pregnant women given the vaccine is yet to be published for Scotland.

In Northern Ireland, no data has yet been published on flu vaccine uptake among pre-school children or pregnant women. But 84% of over-65s had gone for a flu vaccine as of January 3, a figure already far higher than the 55% of over-65s vaccinated throughout the whole of last winter.

‘Dramatic increase’ in flu hospitalisations

Hospital admissions for flu are at their highest levels in at least 10 years in England, according to the UK Government.

Health and Social Care Secretary Steve Barclay said: “There has been a dramatic increase in hospital admissions for flu and we are seeing the highest levels of hospital admissions we’ve seen in at least a decade. There are currently over 5,000 hospital beds a day taken up by flu patients, compared to just 50 this time last year.”

Dame Jenny Harries, chief executive of the UK Health Security Agency, said: “In the week leading up to Christmas, we saw a dramatic increase in the number of people admitted to hospital with flu, with the highest levels of hospital admissions we’ve seen in at least a decade. Admissions were particularly high in the under-fives and those 65 and over.

“I urge all those eligible to come forward for their free flu vaccination, which is the best way to protect yourself from serious illness.  Uptake of the flu vaccine is particularly low in children aged two and three so if your child is eligible please urgently take up the offer.

“Frequent handwashing with soap and warm water, catching coughs and sneezes in tissues and keeping your home well ventilated can also help stop viruses from spreading.

“Try to stay home when unwell and if you do have to go out, wearing a face covering can help prevent germs spreading to other people. Don’t visit vulnerable people if you’re unwell.”

How to get a free flu vaccine

In England, the following people are eligible for a free flu jab.

• people aged 50 and over
• those aged between six months and 49 years with a specified health condition
• some secondary school-aged children
• 2 and 3-year-olds
• pregnant women
• primary school-aged children
• those in care homes
• people who are carers, as set out in the Green Book
• frontline healthcare workers
• frontline social care staff who do not have access to occupational health schemes
• household contacts of people with weakened immune systems.

You can book an appointment at your local pharmacy, GP or via the National Booking Service. Those not eligible can pay for a flu vaccine at many pharmacies.

Eligibility criteria for a free vaccine can vary in other home nations.

In Scotland, you can check your local health board website or their social media channels to find out if there are drop-in clinics available in your area. Pregnant people are advised to speak to their midwife about getting a vaccine. If you’re an eligible health or social care worker, you can drop in at a winter vaccine clinic to get vaccinated - you don’t need an appointment.

In Wales, find out how to get a free flu vaccine via your local health board.

In Northern Ireland, when and where you get your vaccine will depend on which eligible group you belong to. For more details, visit the NI Direct website.